Meeting the Healthcare Cost and Quality Challenges

About five years ago I found myself in an Emergency Room at 5:00 a.m. on a Monday morning with a bad case of bronchitis. As I was resting in an examining room, a nurse came walking in. I watched as she approached the cabinets on one side of the room and started opening drawers. She opened one … and two … and three … and finally found what she was looking for, a pair of latex gloves. I was getting bored and decided to do some Lean fact-finding and asked her, “How do you know which drawer the latex gloves are in?” She quickly answered, “I have to open the drawers.” Getting more curious, I asked another question, “Are the latex gloves in the same drawer in each of the examining rooms?” She answered in a tone of voice that reflected both a bit of impatience at my nosiness coupled with the belief that she was describing a rational world. Her answer, “No, they’re not.” I was struck by the absolute innocence of her response. She seemed to see nothing at all odd about what she had said.

Yet, you and I as “outside” observers of this encounter can, in our mind’s eye, “look” at it and say to ourselves, “how irrational.” And, of course, what I just described is irrational. But the really important issue is not that you and I can see this behavior as irrational. The heart of the matter is that the nurse didn’t. On the contrary, she saw her behavior as normal. Here was an individual who was a well-educated, trained, and dedicated health care professional that each day wasted time while engaged in the irrational pursuit of latex gloves hidden in anonymous examining room drawers. Why did it never occur to her to work with her teammates in the ER in a meeting focused on this question: In which drawer in our examining rooms should latex gloves be located? And, after reaching consensus on this question, to agree that: 1) the gloves should be in the same drawer in each of the hospital’s fifteen examining rooms, and 2) the drawers should be clearly labeled, “Latex Gloves.” But back to the question, “Why didn’t these simple steps occur to her?”

I believe the answer has to do with the way the human brain operates. My years of working in a wide variety of work places, helping teams implement Lean work processes have taught me that you and I – in fact, all human beings – have the ability to work in highly dysfunctional work spaces and view them as normal. And, as a result, we have little motivation to change these dysfunctional spaces. In fact, we never see the need to quit searching for the latex gloves until reality comes crashing in with a loud voice telling us that we’ve got to become more productive – that we’ve got to produce higher quality – that we’ve got to cut down on waste – that we’ve got to optimize our work processes. And at that point, it’s sometimes too late for some organizations. But the lucky ones hear the clarion call in time and act upon it, initiating a serious effort to implement the basic beliefs of Lean manufacturing, coupled with Lean thinking and Lean analytical tools.

What are the basic beliefs that underlie Lean and are the foundation upon which its success is built? They are that:

All work processes are imperfect.

Driving work processes toward perfection must be done by tapping the creativity and knowledge of the individuals who do the work.

The primary job responsibility of all levels of leadership, from front line supervisors to CEOs, is to serve as catalysts, triggering the creativity of their direct reports and focusing the organization on the relentless pursuit of perfection.

Just as these beliefs, coupled with the tools of Lean Manufacturing such as 5S, Value Stream Mapping, Work Cell Redesign, Pull Production, Continuous Flow, Standardized Work, and others have driven remarkable increases in the productivity of manufacturers; they are also having a very positive impact on health care costs as well as the quality of health care services.

The Corporate Solutions Group of St. Louis Community College has well tested resources to support a health care facility’s successful implementation of Lean thinking and work processes. For example, our Kaizen Thinkingseries is an ideal way to prepare health care employees to successfully launch a Lean transformation. In addition, over the last ten years, hundreds of managers and supervisors have honed the skills needed to implement Lean work processes through participation in our Lean Leadership Certification Program. Also, our recently developed Toyota KATAseries, focused on Mike Rother’s highly acclaimed book of the same title, builds the skills needed by managers and supervisors as they work to make improvement and adaptation part of everyday work throughout the organization.

I’d like to meet with you to review the ways in which these resources and others could serve you as your hospital, medical office, nursing or assisted living facility works to meet the cost and quality challenges of the 21st Century through the application of Lean thinking and Lean work processes. Call me, George Friesen, at 314-303-0612 and let’s schedule a meeting.

About George Friesen

George Friesen serves as Business Practice Leader - Lean Manufacturing for the Workforce Solutions Group of St. Louis Community College. He has led the College's Lean business practice area since 2000. Prior to joining the College, George worked for Maritz Performance Improvement Company. Over the past 35 years, he has served a wide variety of Fortune 500 companies, specializing during the past eleven years in Lean Manufacturing, focusing especially on the 5S System, Lean leadership and thinking processes, Value Stream Mapping, and Lean team building. George is a graduate of Washington University (AB), Webster University (MA), and United States Air Force Flight Training.

About Us

The Workforce Solutions Group of St. Louis Community College leverages education for growth in the knowledge economy by offering programs and services designed to advance people, businesses and communities.

We are located at the Corporate College, a state of the art facility solely dedicated to corporate education and professional development.